The intervention strategies and service model for pharmacist-led diabetes management: a scoping review.

BACKGROUND: There is increasing intervention activities provided during pharmacist-led diabetes management. Nevertheless, there is an unclear definition of the activities involved during the intervention. Thus, this study aimed to describe the type of intervention strategies and service model provided during pharmacist-led type 2 diabetes management and service outcomes. METHODS: This study utilized the scoping review methodology of the Joanna Briggs Institute Reviewers' Manual 2015. Articles on pharmacist-led diabetes management focusing on the service content, delivery methods, settings, frequency of appointments, collaborative work with other healthcare providers, and reported outcomes were searched and identified from four electronic databases: Ovid Medline, PubMed, Scopus, and Web of Science from 1990 to October 2020. Relevant medical subject headings and keywords, such as "diabetes," "medication adherence," "blood glucose," "HbA1c," and "pharmacist," were used to identify published articles. RESULTS: The systematic search retrieved 4,370 articles, of which 61 articles met the inclusion criteria. The types of intervention strategies and delivery methods were identified from the studies based on the description of activities reported in the articles and were tabulated in a summary table. CONCLUSION: There were variations in the descriptions of intervention strategies, which could be classified into diabetes education, medication review, drug consultation/counseling, clinical intervention, lifestyle adjustment, self-care, peer support, and behavioral intervention. In addition, most studies used a combination of two or more intervention strategy categories when providing services, with no specific pattern between the service model and patient outcomes.

[Systematic analysis on chemical constituents of Mori Cortex, mulberry root bark and its phellem layer based on HPLC-ESI-MS].

In this study, HPLC-ESI-MS and HPLC methods were established to explore the differences in the main chemical components and content of Mori Cortex with(mulberry root bark) and without(Mori Cortex) the phellem layer from both qualitative and quantitative aspects. The HPLC-ESI-MS method was used for quality analysis in positive and negative ion modes, and 33 compounds were identified in mulberry root bark, 22 compounds in Mori Cortex, and 26 compounds in phellem layer; mulberry root bark and Mori Cortex shared 22 components, and mulberry root bark has 11 unique compounds; Mori Cortex and its phellem layer shared 15 components, while Mori Cortex has 7 unique compounds. HPLC method was used to simultaneously determine 7 major constituents, including mulberroside A, chlorogenic acid, dihydromorin, oxyresveratrol, moracin O, kuwanon G, and kuwanon H, and the developed method showed good linearity(r>0.998 9) within the concentration range and the recoveries varied from 99.88% to 103.0%, and the RSD was 1.7%-2.9%. The HPLC results showed that the contents of the 7 compounds have great differences in 13 batches samples, compared with mulberry root bark, the contents of mulberroside A, chlorogenic acid, dihydromorin and moracin O of Mori Cortex were increased, while the contents of oxyresveratrol, kuwanon G and kuwanon H were decreased after peeling process. These results can provide a basis for the rationality and quality control of Mori Cortex required to remove the phellem layer.

Patient-centered education in dyslipidemia management: a systematic review.

Background: Dyslipidemia management is crucial to reduce mortality and morbidity from cardiovascular diseases (CVDs). Patients must be educated and empowered to enable them to manage their own diseases. Various methods of patient education, such as patient-centered education (PCE) or non-PCE (such as didactic education or any traditional form of education), have been implemented. Objective: To review and determine the effectiveness of PCE for dyslipidemia management compared with usual care. The primary outcome chosen was cholesterol level. Other measures, such as psychosocial or cognitive, behavioral, and other relevant outcomes, were also extracted. Additionally, underlying theories and other contributing factors that may have led to the success of the intervention were also reviewed and discussed. Methods: We conducted searches in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Google Scholar from inception until April 2021. All studies involving randomized controlled trials were included. Study quality was assessed using the Critical Appraisal Skills Program (CASP) checklist specifically for randomized controlled trials. Results: The search identified 8,847 records. Of these, 20 studies were eligible for inclusion. Interventions using a PCE approach were largely successful. Contributing factors extracted from the included studies were underlying theories, instant reward system, dietary education, collaborative care, duration of intervention with systematic follow-ups, social support, adherence assessment method, and usage of e-health. Conclusions: PCE is successful in achieving the desired outcomes in dyslipidemia management. Future studies may incorporate the elements of PCE to improve the management of dyslipidemia in hospital or community settings where appropriate.

[Secretory Expression of the Superactive [Lys(17,18),Glu(21)]-Glucagon in E. coli].

One of the most important findings in structure-function studies on glucagon by means of chemical synthesis is the discovery that [Lys(17,18),Glu(21)]-glucagon had higher biological activity than native glucagon. This mutant of glucagon was called superactive glucagon (SA-glucagon). In the present work, the possibility to obtain SA-glucagon by means of genetic engineering was studied. The gene of SA-glucagon (SAG) was obtained by PCR from a constructed recombinant glucagon plasmid, pAGluT. A secretory expression vector harboring SAG, pBLSG7, containing P(L) promoter and the gene of phoA signal peptide was constructed. In expression studies after transformation of pBLSG7 into E. coli BL21, it was found that the expression yield of SA-glucagon reached 3.65 mg/L(A(600)=1), about 19.5% of total proteins in the culture medium under shaken flask conditions. In addition, the influence of induction temperature and of E. coli strain on the expression yield of SA-glucagon was also studied.